在为时已晚之前提防压力和过度劳累
by Mark Mordecai
从2008年个人保护设备电子通讯中，由
Over the past decade, the number of firefighter on-duty deaths has remained persistently high (about 100) despite significant improvements in personal protective equipment. Providing better gear, although critically important, has had the unintended consequence of allowing firefighters to go deeper into buildings and for longer periods of time, which exposes them to even more risk.
To reduce firefighter fatalities, we have to look at the causes of on-duty deaths. The single largest cause, resulting in nearly half (45%) of all deaths, according to the U.S. Fire Administration ,1is stress/overexertion. Physiological Status Monitoring (PSM) helps identify when a firefighter is in high-risk physiological stress前he becomes a fatality.
消防员面临着与压力和过度劳累相关的独特风险因素。其中包括奥兰治县消防局进行的一项研究2are as follows:
- Sudden nervous system surges caused by unexpected alarms.
- 快速从低水平的劳累转移。
- Carrying, lifting, and wearing heavy protective gear and equipment.
- Prolonged exposure to high temperatures.
- Excessive fluid loss.
In firefighting, all of these risk factors are often present together. When you break down the risk to a firefighter of a fatal cardiovascular event by activity, according to the New England Journal of Medicine,3you can readily see a pattern:
- 32% during fire suppression.
- 17% returning from an alarm.
- 13% responding to an alarm.
- 9% during nonfire emergencies.
- 13% during physical training.
- 15% during nonemergency duties.
Although responding to, working at, and returning from an emergency take up a relatively small portion of the total time a firefighter is on duty, they make up more than two-thirds of all on-duty fatalities. When you factor in the time spent in each activity, the odds of a fatal on-duty cardiac event are 10 to 100 times greater during fire suppression than nonemergency duty, two times greater than for police officers, and three times greater overall than for all workers.4It’s no wonder that the International Association of Fire Fighters, the International Association of Fire Chiefs, and the National Volunteer Fire Council are all strong advocates for health, wellness, and fitness programs for firefighters.
In addition, The National Fire Service Research Agenda Symposium5identified several aspects of firefighter health, wellness, and fitness issues as the highest priority for further research and action, including candidate selection and assessment, health maintenance, identifying risk factors for cardiovascular disease, physiological effects of heat stress and incident response, and functional capacity evaluation. Physiological Status Monitoring is a tool that can be used in all of these areas. Clearly, the fire service has recognized the problem and is aggressively looking for solutions.
A Globe advertisement from a 1908 issue ofFire and Water Engineering, the magazine which came to be known as188金宝搏是正规吗.Click to enlarge
创新的新技术
当今大多数活跃的人都知道跑步者使用的心率监测器和健身锻炼。该目的是监测您的心率，使您可以在心率“区域”中花费尽可能多的时间，这通常是根据年龄的最大预测心率的百分比。这些通常基于皮带的系统通过短距离信号通信到类似手表的设备以监视您的锻炼。这些系统是生理状态监测的基本版本，但它们不足以满足消防服务的需求。
A new and more technically advanced PSM system is now being developed by a team led by Globe and Foster-Miller for use by the military and the fire service. It embeds a built-in sensor system into a moisture-wicking and fire resistant T-shirt that would be worn in place of the current, cotton T-shirts that almost every firefighter wears today. These sensors measure heart rate, respiration rate, skin temperature, activity level, and posture. The data are collected and transmitted in real time as packets of information to a tiny receiver plugged into a laptop computer. If the system detects a potentially dangerous condition, it can alert the individual and the incident commander to pay attention before it’s too late. And it can record the data for post-activity analysis if the need arises.
消防申请
So how can the fire service use such a system? One way is as part of an individually tailored fitness workout program. An easy-to-use graphical user interface would show how you are doing, and the data could be logged to see how you are progressing toward your fitness goals, while providing training history and analysis. As with any fitness program, seeing progress is motivational.
Another use of the PSM system is in academy training. Providing real-time monitoring of each member of the team and a visual and audible alert to situations requiring attention could provide a critical early warning of potentially dangerous levels of stress and overexertion. By quantifying in a training environment just what the members of the team were experiencing during the session, individuals would have a better awareness of the importance of conditioning. And, as the need for training increases, the fire service can’t afford to lose anyone in training.
Hazmat operations and training are also well-suited for Physiological Status Monitoring. An encapsulated Level A suit is one of the most difficult protective ensembles in which to work, as the heat and moisture buildup puts more strain on your body. Feedback from hazmat personnel during PSM system testing indicates it is reassuring for personnel to know that someone is looking out for them, allowing them to focus on the job at hand. And current metrics for the amount of safe working time in hazmat operations are based on estimates of temperature, workload, and exposure. Monitoring the actual workload and vital signs may let personnel stay in longer to finish a job or warn them to come out sooner.
当然，生理状态监测有助于减少火场死亡。在操作过程中，系统可以远程提醒事件指挥官需要注意的情况。它可以用作当前通行设备的电子备份。它可以为康复提供立即的重要数据。
测试
我们怎么知道PSM系统有效？第一步是在实验室环境中比较T恤收集和传输的数据与在锻炼过程中的“金标准”医学ca仪之间进行比较，既有完整的消防装备，又没有。188金博网网址多少这项测试表明，两组数据（超过90％）之间的呼吸率和心率之间存在良好的相关性。绘制这些数据点表明，T恤数据可能比capnograph更准确，这是最可观察到的差异的。6
就初步现场测试而言，已经在美国陆军特别行动和Hazmat OPS以及Santa Ana（CA）消防局的A Hazmat Ops的培训中进行了实地试验。这些试验验证了在发行的传感器，信号和编程功能下作为基础层的可穿戴能力。
In the near future, there are plans to conduct more extensive operations field trials in the fire service for use in everyday firefighting duty with the Oxnard (CA) Fire Department and the Boston (MA) Fire Department. Many departments across North America have volunteered to conduct beta testing of these systems as we move forward.
更多研究
现在，研究专注于以其他方式使用PSM。在一个项目中，伍斯特理工学院（WPI），福斯特·米勒（Foster-Miller），格兰特（Globe）和伍斯特（MA）消防局正在努力将消防员的位置与生理状态监测整合在一起。这个绝对未来概念的目的是使用具有直观图形接口的笔记本电脑实时地定位，跟踪和监视整个多层次结构的单个机组人员。这是一个雄心勃勃的项目，但是它已经在消防员位置展示了令人兴奋的潜力，并验证了使用PSM系统作为额外功能的平台的能力，因为这些技术变得可用。
Another soon-to-be-launched research project is looking at the physiological status of firefighters while on duty, studying the relationship of this status to the user’s fitness level and using the data to set appropriate physiological parameters for firefighters.
Are You Ready?
As with most new technology, the question is often asked whether the fire service is ready to adopt it. A survey taken during the IAFF Redmond Symposium in 2007 revealed that more than 85% of the health and safety audience was willing or very willing to wear a T-shirt incorporating PSM.7A similar survey conducted at FDIC 2008 showed that more than 90% of this broader spectrum fire service audience was willing or very willing to wear a T-shirt incorporating PSM.8
我们正处于了解消防员因压力和过度劳累死亡的根本原因。我们有一项工作的新技术，即生理状态监测，可以在为时已晚之前提供警告。该技术可以像用技术先进的T恤替换常见的T恤一样容易地部署，该T恤包含不引人注目的传感器和微型发射器。包括T恤，传感器，发射器，信号，接收器和编程的系统正在为军事和消防应用开发。188金博网网址多少正在进行的研究和测试将提供有关执行实际消防职责范围的消防员生理状况的重要数据。消防部门愿意穿它。
没有人期望部署这项新技术会阻止所有值班的消防员死亡或残疾人的压力和过度劳累，但是请考虑到它对受影响的个人，他们的家人及其部门的重要性，甚至在此之前识别一些为时已晚。
参考
1. U.S. Department of Homeland Security (DHS), Federal Emergency Management Agency (FEMA), U.S. Fire Administration,2006年美国的消防员死亡人数, July 2007.
2.南希·埃斯皮诺萨和迈克尔孔特雷拉斯,或ange County Fire Authority,Safety and Performance Implications of Hydration, Core Body Temperature, and Post-Incident Rehabilitation, Final Report December 2007.
3. Stefano N. Kales，Elpidoforos S. Soteriades，Costas A. Christophi和David C. Christiani，“美国消防员中心脏病的紧急职责和死亡”，新英格兰医学杂志, March 22, 2007.
4.同前。
5.国家堕落的消防员基金会，国家消防研究议程研讨会的报告，2005年6月1-3日。
6.吉姆·达克沃思（Jim Duckworth），伍斯特理工学院，Integrated Firefighter Location and Physiological Monitor, Presentation to the Worcester County Fire Chiefs Meeting, April 17, 2008.
7. Globe Manufacturing Company,Fire Service Survey: Physiological Status Monitoring, Redmond Symposium, October 2007.
8. Globe Manufacturing Company,消防调查：生理监测, Fire Department Instructors Conference, April 2008.
Mark Mordecai is director of business development for Globe Manufacturing Company, where he is responsible for driving product development and marketing. Globe, manufacturer of NFPA-compliant firefighter suits, produces a range of premium performance personal protective equipment for fire, rescue, emergency medical, and other first responders.
